Night Shift Research Articles

Christmas article: From diagnosis to delicacy: using MR and DXA scanners to roast Christmas duck

The holiday season poses a unique challenge for hospital staff, especially on night shifts, who must juggle their duties with preparing a festive Christmas meal. This study investigates the novel idea of using hospital MRI scanners to cook duck breasts during shifts. MRI scanners, which use magnetic fields and radiofrequency (RF) pulses for imaging, also generate heat, potentially suitable for cooking. To explore this hypothesis, we performed DXA scans on duck breasts to determine tissue composition and identify any metallic objects, such as shotgun pellets, that could pose risks in the MRI environment. We examined the Specific Absorption Rate (SAR), which measures RF energy absorbed by tissue. Given the similar water content between duck muscle and human tissue, we used human SAR values for our calculations. Our findings suggest that with careful adjustment of RF amplitude, magnetic field strength, and scan duration, it is theoretically possible to cook a duck breast to an internal temperature of 62°C within a standard 8-hour hospital shift. While the idea of using MRI scanners for cooking is intriguing, patient care must remain the priority. The limited availability of MRI scanners for culinary use may limit its practical application. Further research could explore cooking other holiday dishes and address logistical challenges for broader implementation. None. None.

Interventions to reduce burnout in emergency medicine: a national inventory of the Canadian experience to support global implementation of wellness initiatives.

Burnout in healthcare workers is a global issue, with Emergency Medicine (EM) particularly impacted. Many countries have tried implementing wellness initiatives to reduce burnout and improve wellness. This paper summarizes interventions implemented in Canada to-date with the aim of supporting the design of wellness interventions in EDs globally. A systematic review and a grey literature search were completed in November 2023. Original studies in both English and French that included the implementation and evaluation of a wellness intervention in EDs in Canada were included. The study design, content of the intervention, target population, and outcomes were extracted and narratively analyzed. 13 studies were included. Each implemented a unique wellness intervention for EDs. All three studies (3/3, 100%) that included a structured wellness curriculum demonstrated significant improvement in burnout as measured by the Maslach Burnout Inventory, physical health (PCS-8), and Brief Resident Wellness Profile (BRWP). Other interventions included Ice Cream Rounds, therapy dogs, changing the duration of night shifts, and sessions on resilience and self-care. Our Canada-wide analysis of wellness interventions identified initiatives geared towards trainees, staff, or entire ED workface groups. Examples include educational programs, dedicated sessions for compassion literacy and resilience, critical events debriefing, and optimizing shift schedules. Structured wellness curriculums seem to be effective, and this area warrants further study. Moreover, we identify a need for global collaboration to build wellness programs and for more easily translatable standardized outcome measures for assessing the efficacy of wellness programs in EM.

Sex differences in burnout and work-family conflict among Chinese emergency nurses: a cross-sectional study

IntroductionWork–family conflict and burnout have become pressing concerns in nursing profession. These factors negatively affect nurses' health and work performance and therefore negatively influence the quality and safety of patient care. Whereas, nursing is a female-dominated profession. Studies have found that male nurses have higher level of depersonalization dimension of burnout than female nurses. Female nurses present higher level of emotional exhaustion dimension of burnout than male nurse. This study aimed to apply sex-specific analyses to investigate the associations between dimensions of burnout and work–family role behavior conflict among Chinese emergency department nurses.MethodsThis was a cross-sectional research. A questionnaire comprising items on demographic characteristics, work–family role behavior conflict, and burnout information, was distributed among emergency department nurses from 30 tertiary hospitals across mainland China, between December 26, 2023, and January 18, 2024.ResultsThis study's sample comprised 1,540 nurses. The total work–family role behavior conflict scores were 42.23 and 43.4, and the total burnout scores were 11.14 and 11.63 for female and male nurses, respectively. Significant differences were observed in comparisions of age, marital status, fertility status, education level, job title, work experience, night shift frequency, smoking status, and drinking status by sex. Correlation analyses revealed that burnout and work–family role behavior conflicts were positively associated with both sexes. Multiple linear regression analyses indicated that three dimensions of burnout including emotional exhaustion, depersonalization, and reduced work accomplishment significantly affected work–family role behavior conflict in both sexes. Compared with emotional exhaustion and reduced work accomplishment dimensions, depersonalization dimension of burnout affected work–family role behavior conflicts the most in male emergency nurses. Emotional exhaustion and depersonalization dimensions of burnout explained more of the variance in work–family role behavior conflict compared with redeuced work accomplishment dimension for female emergency nurses.ConclusionReducing depersonalization among emergency department male nurses and emotional exhaustion and depersonalization for female emergency department nurses, are crucial for decreasing work–family role behavior conflicts. Future studies should explore differences in burnout level among male and female nurses for a long time.

Role of turnover, downsizing, overtime and night shifts on workplace violence against healthcare workers: a seven-year ecological study

BackgroundAbout one-third of workers identify organisational factors as contributors to workplace violence (WPV), but the associations between these factors and WPV have primarily been explored retrospectively and with measures of perceived organisational constraints, hence providing limited information for prevention. Therefore, we assessed whether objectively measured ward-level indicators of turnover, downsizing, overtime, and night shifts are associated with the occurrence of WPV and whether these associations vary by ward type.MethodsWe conducted an ecological study at a university hospital in northern Italy from 2016 to 2022, using wards as statistical unit (average: 230 wards per year). Active surveillance of WPV was based on an in-hospital incident reporting procedure, updated in November 2021 based on Health Regional Administration guidelines; 2021 was therefore excluded as a transition year. Individual-level administrative data were used to compute ward-level yearly indicators of turnover, downsizing, overtime and night shifts per active worker. Using generalised linear models, we estimated rate ratios (RRs) for yearly WPV counts per 1 SD increase in the indicators, controlling for study period, ward type (emergency department [ED], psychiatric ward, other) and ward sociodemographic composition.ResultsA total of 337 WPV episodes occurred in the 1381 ward-year observations. The WPV rates per 100 active workers per year increased from 1.40 (95%CI: 1.23–1.60) during 2016–2020 to 3.48 (2.90–4.17) in 2022. Higher turnover (RR, 95%CI: 1.47, 1.23–1.75) and downsizing (1.12, 1.00-1.24) were associated with a greater occurrence of WPV across all wards; these associations were consistent across the study periods. In wards with night shift scheduling, turnover (1.64, 1.40–1.92), downsizing (1.21, 1.04–1.40) and the mean number of night shifts (2.50, 1.37–4.56) were associated with WPV. The association between night shifts and WPV was greater in psychiatric wards (RR = 8.73; interaction p-value = 0.02), whereas the role of downsizing was greater in EDs (RR = 1.42, interaction p-value = 0.09) and the role of turnover was greater in the other wards (RR = 1.34, interaction p-value = 0.16).ConclusionWork organisational factors are associated with the occurrence of WPV episodes against healthcare workers. Ward type-tailored priorities should be given to minimising turnover and downsizing and promoting a fairer allocation of night shifts to decrease WPV occurrence.

Comparison of Nurse Work Hours and Nursing Activities Between High- and Low-Staffed General Wards: A Cross-Sectional Study.

To compare nurse work hours and nursing activities between high-staffed and low-staffed general wards to examine the effects of increased staffing on nurse workload and nursing care. A secondary analysis was conducted using cross-sectional data collected at a tertiary teaching hospital in South Korea in January 2020. Nursing activities provided by 350 nurses were observed every 10 min during their shifts for three observation days in four high- and four low-staffed wards. Nurse-to-patient ratios, nurse work hours, nursing activities and the composition of nursing hours (direct care, indirect care and associated work) were analysed. After excluding non-productive personal time, nurses in the low-staffed wards worked 9.28 h, which indicates 1.28 h of overtime work on average, while the high-staffed wards recorded 7.90 h of productive work time. The nurse-to-patient ratio in the high-staffed wards was 1:4.73, whereas that in the low-staffed wards was 1:8.87. The proportion of direct care hours out of nurse work hours was higher in the low-staffed wards (30.9%) than in the high-staffed wards (25.7%). Nurses in the low-staffed wards provided a greater number of direct care hours, and the largest difference in direct care hours between the two groups was found on night shifts. Nurses in the high-staffed wards spent more time communicating with patients and charting, whereas nurses in the low-staffed wards spent more time on vital signs and medications. Improved staffing had positive impacts on patients and nurses. Patients benefited from better staffing through increased communication with nurses. Better staffing also reduced overtime work and activities conducted during night shifts. Adequate staffing is essential to improve patient care quality and reduce nurse workload. Nursing activities must be prioritised and redesigned to maximise the benefits of increased staffing on patient and nurse outcomes. We have adhered to the STROBE reporting guidelines. The aim of this study was to compare nurse work hours and nursing activities between high-staffed and low-staffed wards.

Exploring barriers and facilitators in nurses’ reporting of patient and visitor violence: a cross-sectional study in China

ObjectivesThe current status of patient and visitor violence (PVV) reporting among nurses has proven insufficient. Therefore, we explored the barriers and facilitators in nurses’ reporting of PVV.DesignCross-sectional study.SettingGeneral and specialised...

Searching for a Serial Killer on a Hospital Ward

The recent case of Lucy Letby in the UK shows that exposing a serial killer in healthcare is challenging. Statistical evidence has been used in the courts, but the overturning of the life sentence of a Dutch nurse in 2008 due to inadequate data analysis suggests the need for objective statistical approaches. In our case, a nurse was convicted after injecting an infant with insulin following a dispute at a family party and killing a patient with insulin in an institute for disabled persons. The nurse had previously worked in a geriatric unit for seven months, during which 29 deaths occurred, some with suspicious features.We applied statistical methods developed for the evaluation of diagnostic tests to analyze the nurse’s possible involvement in these deaths. We searched for discrepancies in the death certificates and performed medico-legal autopsies on exhumed deceased patients.During the 7 months, 69 nurses and practical nurses at the geriatric ward completed 27,324 shifts. Of the deaths, 16/29 (55%) occurred during night shifts. The convicted nurse had worked a clearly higher number of night shifts, in particular, than others. She was among the highest 10% whose work shifts coincided with the deaths in terms of sensitivity, specificity, and likelihood ratios. Of the deaths, 11/29 (38%) occurred during or immediately after her shift. Unexplained suspicious blood glucose fluctuations or hypoglycemia-mimicking comas unrelated to known illnesses were reported in 6 (55%) of the 11 deaths, and in one of these cases, the incident was supported by autopsy findings.Statistical methods for diagnostic accuracy may allow the targeting of the investigation when searching for a possible serial killer in a hospital. However, a statistical approach does not allow an unambiguous determination of a perpetrator nor does it replace a thorough examination of the circumstances and cause of death when investigating a small number of suspicious deaths among patients with serious illnesses and high mortality.

Work Reward Moderates the Association Between Work Effect and Workplace Violence Among Medical Staff in China.

Workplace violence (WPV) against healthcare workers is a significant public health issue in China and globally. Although the effort-reward imbalance theory claimed that work rewards may moderate the relationship between work effort and WPV, the quantitative evidence is limited. This study aimed to examine if work reward could moderate the associations between work effort and WPV against medical staff based on the effort-reward imbalance theory. This is a cross-sectional study, which was conducted in 12hospitals in Shandong, China. Data collected from 3426 medical staff were analyzed in this study.Work effort was evaluated by working hours and night shift work times per month (NSWM), and work reward was evaluated by monthly income and perceived social status. WPV, occupational characteristics, physical disease, and social-demographic variables were also evaluated in this study. There were 1788 (52.2%) medical staff, who reported the experience of workplace violence. Working hours, NSWM, and perceived social status were associated with WPV (all p<0.001). Monthly income could moderate the associations between monthly income and WPV or verbal violence (p<0.05), and perceived social status could moderate the associations between NSWM and WPV (p<0.001). Monthly income could moderate the associations between monthly income and WPV (verbal violence), and perceived social status could moderate the associations between NSWM and WPV, which could be explained by the effort-reward imbalance model. These findings also can be translated into practices to control WPV against medical staff.

Sleep quality and hours of nurses according to shift type and schedule: A cross-sectional study

ABSTRACT This study investigated the quality and duration of sleep among shift-working nurses. In this cross-sectional survey, nurses from eight units across two tertiary hospitals in South Korea’s capital region participated. We collected data on sleep quality and duration from 117 nurses. We used the Mann-Whitney test, analysis of variance, or the Kruskal-Wallis test to analyze differences in sleep quality and duration across different shifts. The nurses generally reported low sleep quality, with sleep disturbances being the most common issue. The worst subjective sleep quality was associated with the night shift, while the shortest sleep duration was reported for the day shift. Nurses working two consecutive night shifts reported the poorest sleep quality and shortest sleep duration. The quality and duration of sleep for shift-working nurses varied depending on the shift type. There were also differences based on the arrangement of multiple consecutive shifts. The findings of this study suggest that planning for nurses’ shift work should consider sleep quality and duration. Specifically, nurses working the night shift reported poor sleep quality and duration, indicating a need for strategies to ensure they get sufficient rest after their shifts.

FATORES ASSOCIADOS A QUALIDADE DE VIDA DE PROFISSIONAIS ATUANTES NA ATENÇÃO HOSPITALAR

The objective of this study was to analyze the factors associated with the quality of life of professionals working in hospital care. An integrative literature review was conducted, and articles retrieved from the secondary databases Virtual Health Library, Latin American and Caribbean Literature in Health Sciences, Scientific Electronic Library Online and Online System for Search and Analysis of Medical Literature were analyzed from the descriptors quality of life, health personnel and hospital care from the Boolean operators. In the analysis of the selected studies, it was identified as associated factors the work in special and closed units, low pay, work overload, night work, double employment, organizational support, patient profile and length of service. Quality of life should be the focus of systematic occupational health actions to enable a more satisfactory work environment and better professional care.

Night shift work, poor sleep quality and unhealthy sleep behaviors are positively associated with the risk of epilepsy disease

BackgroundNight shift work and poor sleep quality are gradually becoming more prevalent in modern society. Nevertheless, there have been limited studies assessing the association between night shift work, sleep behaviors, and risk of epilepsy. The aim of our study was to ascertain whether a positive association exists between night shift work, sleep quality, sleep behaviors, and risk of epilepsy.MethodsOur study included a total of over 270,000 individuals with or without epilepsy from the UK Biobank, followed up over a period of 13.5 years. Information on current night shift work and major sleep behaviors was also obtained. We used Cox proportional hazard models to assess the association between night shift work, sleep quality, sleep behaviors, and the risk of epilepsy after adjusting for multiple variables.ResultsNight shift work was positively associated with a higher risk of epilepsy (P for trend = 0.059). There was a gradual increase in epilepsy risk from ‘never/rarely’ to ‘usual/permanent’ night shifts, with ‘usual/permanent’ night shifts work presenting the highest risk [hazard ratio (HR) 1.29, 95% confidence interval (CI) 1.01–1.65). Additionally, there was a significant association between sleep quality and risk of epilepsy (P < 0.001). Among the five major sleep behaviors, sleep duration (< 7 or > 8 h/day), frequent insomnia, and daytime sleepiness were significantly associated with a higher risk of epilepsy (HR 1.19, 95% CI 1.11–1.28; HR 1.19, 95% CI 1.09–1.30; HR 1.46, 95% CI 1.24–1.72, respectively). Furthermore, sleep duration exhibited a ‘U-shaped’ association with epilepsy risk. Nevertheless, no significant association was found between sleep chronotype and snoring and the risk of incident epilepsy (HR 1.04, 95% CI 0.96–1.12; HR 0.96, 95% CI 0.89–1.04).Conclusions‘Usual/permanent’ night shifts and poor sleep quality were positively associated with a greater risk of incident epilepsy. Major sleep behaviors, including unhealthy sleep duration (< 7 or > 8 h/day), frequent insomnia, and daytime sleepiness, also tended to increase the risk of epilepsy.

Prognostic Factors Associated With Survival Distribution of Admission to Delayed Rapid Response Team Activation Among Deteriorating Patients: A Retrospective Study.

To investigate the prevalence of rapid response team delays, survival distribution of admission to rapid response team delay and its prognostic factors. A retrospective single-centre study. Data on rapid response team activations from 1 January 2018 to 31 December 2022 were retrieved from electronic medical records at a tertiary hospital in Hangzhou, China. All patients who met the eligibility criteria were included. Multivariable Cox regression analysis was conducted to analyse the data. Out of 636 patients included, 18.4% (117) experienced a delay, with a median (interquartile range) of 8.5 (12) days from admission to rapid response team activation. Six significant prognostic factors were found to be associated with the higher hazard ratio of rapid response team delay, including call time (05:01 PM and 7:59 AM), emergency admission, a higher Modified Early Warning Score, an admission diagnosis of infection, a comorbidity of respiratory failure/Acute Respiratory Distress Syndrome and the absence of lung infection. The prevalence of rapid response team delays was lower, and the days from admission to rapid response team delay was longer than in previous studies. Healthcare providers are suggested to prioritise the care of high-risk patient groups and provide proactive monitoring to ensure timely identification and management. Implementing artificial intelligence in continuous monitoring systems for high-risk patients is recommended. The findings help nurses anticipate potential delays in rapid response team activation, enabling better preparedness. The study highlights the prevalence of rapid response team delays, timing from admission to rapid response team activation and six prognostic factors influencing delays. It could shape patient care and inform future research. Hospital administrators should review staffing, especially during night shifts, to minimise delays. Further qualitative research is needed to explore why nurses may delay rapid response team activation. The STROBE checklist was adhered to when reporting this study. 'No patient or public contribution'.

Nurses' and Nursing Assistants' Experiences With Teleconsultation in Small Rural Long-Term Care Facilities: Semistructured Interview Pilot Study.

In Quebec, the shortage of nurses during night shifts compromises the safety and quality of resident care, particularly in small residential and long-term care centers ("Centres d'hébergement et de soins de longue durée"; CHSLDs) located in rural areas. The need to ensure the continuous presence of nurses 24 hours a day in CHSLDs has become more pressing, forcing some facilities to implement exceptional measures such as on-call telephone services to ensure access to a nurse. In light of these challenging circumstances, the Direction nationale des soins et des services infirmiers of Quebec's Ministère de la Santé et des Services sociaux has rolled out a teleconsultation pilot project. This study aims to explore nurses' and nursing assistants' experience of integrating teleconsultation during night shifts in rural CHSLDs with ≤50 residents. The 6-month pilot project was rolled out sequentially in 3 rural CHSLDs located in 2 administrative regions of Quebec between July 2022 and March 2023. A total of 18 semistructured interviews were conducted with 9 nurses and nursing assistants between February and July 2023. Participants' experiences revealed that teleconsultation provided significant added value by improving clinical, administrative, and organizational practices. Some practices remained unchanged, indicating stable workflows. Workflow optimization through an expanded scope of practice ensured efficient and safe continuity of care. Enhanced collaboration between nurses and nursing assistants led to improved care coordination and communication. The leadership played a significant role in clarifying professionals' roles and in supporting effective adaptation to teleconsultation. This pilot project represents a significant step forward in improving care for CHSLD residents in Quebec. Teleconsultation not only makes it possible to overcome recruitment challenges and ensure the continuous presence of nurses during night shifts but also optimizes professional practices while ensuring the safety and quality of care provided to residents.

Liver-gut axis signaling regulates circadian energy metabolism in shift workers.

Circadian rhythm is critical to maintaining the whole-body metabolic homeostasis of an organism. Chronic disruption of circadian rhythm by shift work is an important risk factor for metabolic diseases. Fibroblast growth factor 15/19 (FGF15/19), a key component in the liver-gut axis, potently suppresses bile acid (BA) synthesis and improves insulin sensitivity. FGF15/19 emerges as a novel pharmaceutical target for prevention and treatment of metabolic diseases. The nicotinamide adenine dinucleotide (NAD+)-dependent sirtuin 1 (SIRT1) deacetylase plays an important role in the maintenance of hepatic homeostasis by linking hepatic metabolism to circadian rhythm. Here, our clinical study identified that circadian rhythmicity and levels of plasma FGF19 and BA profiling, and cellular NAD+-dependent SIRT1 signaling were disturbed in night shift (NS, n = 10) compared to day shift (DS, n = 12) nurses. Our invitro data showed that recombinant FGF19 protein rescued cellular circadian rhythm disrupted by SIRT1 inhibitors. Furthermore, we determined the effect of FGF15 on circadian rhythm and hepatic metabolism in wild-type (WT), Fgf15 knockout (KO), and Fgf15 transgenic (TG) mice. The expressions of circadian-controlled genes (CCGs) involved in SIRT1 signaling, BA and lipid metabolism, and inflammation were disrupted in Fgf15 KO compared to WT and/or Fgf15 TG mice. Moreover, systemic FGF15 deficiency led to the circadian disturbance of NAD+-dependent SIRT1 signaling and significant reduction during nighttime in mice. These findings suggest that FGF15/19 regulates the circadian energy metabolism, which warrants further studies as a putative prognostic biomarker and pharmaceutical target for preventing against metabolic diseases associated with chronic shift work.

Assessment of Lighting in Medical Facilities from an Occupational Health Perspective

ABSTRACT Although workplace lighting improves employee satisfaction and performance, it may also harm health. It has been established that the lighting in hospitals influences the productivity of the staff. and patient healing ability. This study aimed to assess hospital lighting conditions and determine their impacts. During the first part of the study, lighting measurements were taken and evaluated in compliance with the TS EN 12,464-1: 2021–09 criteria in October and November of 2021. In the second step, 360 people were surveyed to evaluate employee opinions on lighting conditions. The maximum and minimum lighting levels were recorded at different hospital locations. Most participants worked in night shift, with an average age of 36.19 years and an average working time of 9 years. Overall, it was reported that the working and circulation spaces were well-lit. However, falls, cuts, fractures, sprains, bruises, and contusions were the most common lighting-related problems reported by the participants. According to the results, 15.5% of the participants experienced an occupational accident due to lighting. Therefore, modifying hospital lighting standards and implementing steps to protect personnel health are critical.

The correlation of shift work and CLOCK, BMAL1, and PER1 gene polymorphisms with hypertension in healthcare workers: A cross-sectional study

This study aimed to investigate the polymorphisms of circadian clock genes and the association of shift work and gene polymorphisms with hypertension in healthcare workers. This study recruited 222 healthcare workers, of whom 76 had primary hypertension (Hyp group) and 146 served as controls (Control group). General information and working hours were collected through questionnaires. Next, the identification of specific single nucleotide polymorphism (SNP) loci related to the Circadian locomotor output cycles kaput (CLOCK), brain and muscle arnt-like 1 (BMAL1), and PER1 genes was conducted by literature and PDGene database search. Venous blood samples were then collected for DNA extraction, and polymerase chain reaction-restriction fragment length polymorphism techniques were used to analyze the genotyping and allele frequency of the SNP sites. Finally, multivariate logistic regression was employed to analyze the association between various risk factors and hypertension in healthcare workers. Compared to the control group, the Hyp group had significantly higher proportions of alcohol consumption and family history of hypertension, while the average sleep duration and average exercise time were significantly lower. Shift work analysis showed that the Hyp group had a significantly lower average number of evening shifts per month while a much higher average number of night shifts per month compared to the control group. The GG genotype at the CLOCK rs1801260 locus was associated with a lower risk of hypertension (OR = 0.446), and the TT genotype of the BMAL1 rs11022775 locus also showed a similar protective effect (OR = 0.426). However, the genotype distribution of the PER1 rs2735611 locus was not significantly associated with the risk of hypertension. Multivariate regression analysis revealed that a family history of hypertension and insufficient sleep were significantly associated with the risk of hypertension, and the average number of night shifts per month was positively correlated with the risk of hypertension. Specific polymorphisms in the CLOCK and BMAL1 genes may have a protective effect against hypertension in healthcare workers, while polymorphisms in the PER1 gene are not significantly associated with the risk of hypertension. Additionally, a family history of hypertension, insufficient sleep, and shift work patterns may be significant risk factors for hypertension.

The association between vigour and flexibility with injury and alertness during shift work

ABSTRACT Models of shift work and health suggest that individual differences in circadian rhythm characteristics may moderate the relationship between night shift work and injury, but this argument has not been directly tested. In this study, we tested the efficacy of two circadian rhythm characteristics—vigour and flexibility—as moderators of the path between shift work and injury. In addition, we aimed to replicate the association between vigour, flexibility, and alertness by time of day, and the measurement properties of the Circadian Type Inventory. We recruited 401 healthcare workers from Australia and Great Britain. After controlling for confounding variables, the results showed that vigour moderated the association between shift work and injury. Participants with values of vigour at the mean (β = 0.5120, p < 0.0013, 95% CI = [0.2018, 0.8223) and one standard deviation below the mean (β = 0.9048, p < 0.0001, 95% CI = [0.4648, 1.3447] reported significantly more injuries. No moderation was found for flexibility. Significant differences in alertness by time of day were observed in participants with higher levels of vigour compared to lower levels of vigour. No differences in alertness were observed for the flexibility scale. These results indicate that vigour may be a robust indicator of shift work tolerance. We replicated the posited two-factor structure of the Circadian Type Inventory, found the scales to have good reliability, and established for the first time, criterion-related validity for the vigour scale.

Adaptive large neighbourhood search for the multi-depot arc routing problem with flexible assignment of end depot and different arc types

This article introduces an advanced solution to optimize street sweeping operations by extending a multi-depot arc routing problem. The key enhancement involves flexible end depot assignments, where vehicles start and conclude shifts at designated depots. A notable constraint requires subsequent shifts to begin from the destination depot of the preceding shift. The problem involves servicing highway exclusively during night shifts, while other arc types can be addressed during both day and night. The objective is to identify optimal shifts meeting practical criteria while adhering to constraints like maximum shift duration. To address this, a mixed-integer linear programming (MILP) model is presented. It aims to minimize the number of shifts and total travel time. Given the computational complexity of large instances, an adaptive large neighbourhood search (ALNS) metaheuristic was developed. This approach incorporates specialized operators that address unique attributes such as arc type and depot assignments, ensuring arcs are repositioned based on their type and proximity to depots. This tailored approach provides a distinct advantage over classical ALNS operators, as numerical tests indicate that the specialized operators are more efficient in comparison. The approach is evaluated on larger and a real-world instances, demonstrating notable performance in solution quality and computational efficiency.

Burnout crisis in Chinese radiology: will artificial intelligence help?

To assess the correlation between the use of artificial intelligence (AI) software and burnout in the radiology departments of hospitals in China. This study employed a cross-sectional research design. From February to July 2024, an online survey was conducted among radiologists and technicians at 68 public hospitals in China. The survey utilized general information questionnaires, the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) scale, and a custom-designed AI usage questionnaire. This study analyzed the correlation between AI software usage and occupational burnout, and general information was included as a control variable in a multiple linear regression analysis. The analysis of survey data from 522 radiology staff revealed that 389 (74.5%) had used AI and that 252 (48.3%) had used it for more than 12 months. Only 133 (25.5%) had not yet adopted AI. Among the respondents, radiologists had a higher AI usage rate (82.0%) than technicians (only 59.9%). Furthermore, 344 (65.9%) of the respondents exhibited signs of burnout. The duration of AI software usage was significantly negatively correlated with overall burnout, yielding a Pearson correlation coefficient of -0.112 (p < 0.05). Multiple stepwise regression analysis revealed that salary satisfaction, night shifts, duration of AI usage, weekly working hours, having children, and professional rank were the main factors influencing occupational burnout (all p < 0.05). AI has the potential to significantly help mitigate occupational burnout among radiology staff. This study reveals the key role that AI plays in assisting radiology staff in their work. Questions Although we are aware that radiology staff burnout is intensifying, there is no quantitative research assessing whether artificial intelligence software can mitigate this occupational burnout. Findings The longer staff use deep learning-based artificial intelligence imaging software, the less severe their occupational burnout tends to be. This result is particularly evident among radiologists. Clinical relevance In China, radiologists and technicians experience high burnout rates. Even if there is an artificial intelligence usage controversy, encouraging the use of artificial intelligence software in radiology helps prevent and alleviate this occupational burnout.

Examining symptom and quality of life in polycystic ovarian syndrome: a web-based cross-sectional study.

Polycystic Ovarian Syndrome (PCOS) is a reproductive disorder that significantly impacts women's quality of life (QOL). Its unclear etiology, whether genetic or environmental, and the treatments associated with it have been widely studied globally. This study assessed the QOL of 108 women with PCOS, examining both physical and mental symptoms. Participants completed the Short Form-12 (SF-12) questionnaire through a web-based survey to evaluate their QOL scores. Common symptoms included menstrual irregularity (73.14%), hirsutism (65.7%), acne (62.03%), and obesity (22.22%). Complications such as diabetes mellitus (12.9%), hypertension (2.78%), infertility (1.85%), miscarriages (31.4%), hyperandrogenism (68.51%), and insulin resistance (28.7%) were reported. Patients with infertility had the lowest physical scores (PCS), while those working night shifts had the lowest mental scores (MCS). PCOS significantly affects QOL, with infertility contributing to the lowest physical scores and night shift work correlating with the lowest mental scores. These findings emphasize the need for integrated psychological and physical care, particularly for young working women with PCOS.